REPRODUCTION OF TISSUE 
BY 
SPONGE-GRAFTING. 
(Whitney Memorial Prize Essay.) 
CORRESPONDENCE 
READ BEFORE 
THE DENTAL SOCIETY OF THE STATE OF NEW YORK 
MAY 1, 1885, 
V 
W. H. ATKINSON, M. D., D. D. S., 
New York. 
iBB5. REPRODUCTION OF TISSUE BY SPONGE GRAFTING. 
In the whole history of surgery there is no method of so much value 
and so little understood and practiced as that which has been called 
sponge grafting. Like most of the knowledge of principles and modes 
of practice in our specialty, it grew out of the misfortunes arising from 
traumatic or functional lesion. 
The first use made of sponge grafting, in a crude way, was by 
obstetricians to fill the gap of cervical fissure of the uterus, resulting 
from violent and tedious labor. 
I remember the discussions as to what became of the sponge. In 
one case of a very nervous woman, then called “ hysterical,” it was 
questioned whether she did not purposely remove the sponge, although 
she stoutly maintained the contrary. The cases submitted to this 
treatment did so well that this method was kept secret among a few for 
years. At that time, a solution of bi-chloride of mercury in water, 
alone or with sal ammoniac, was the external remedy used for scabies 
(itch). 
Dr. William Woodruff, of Meadville, Pa., at the suggestion of a 
pupil then studying with him, wrung out a sponge in this solution, and 
used it in a badly torn cervix uteri following labor, which healed so 
kindly as to induce him to adopt it in the general treatment of these 
lesions. 
The tediousness of the drainage method of healing large loss. of 
tissue by fibrous tents, rubber tubes, or horse hair or other setons, to 
induce granulation, is greatly abridged by the use of the sponge graft 
in place of the tent, as the latter must be removed before the wound 
can be completely closed by the new growth. Efforts to assist nature 
in healing wounds and in reproduction of lost tissues from traumatic 
or from functional lesion, had been so various, bungling and in- 
human, that it is no wonder that a mere expectant course long held 
dominion in the annals of surgery. From the abhorrent use in surgery 
of the actual cautery in the shape of boiling oil, into which the bleeding 
stump was plunged, red hot irons and embers applied to bleeding 
wounds, and the potential cautery in the shape of the strongest alkalies 
and acids to arrest hemorrhage, the wait-and-watch treatment was established. The lack of any just apprehension of the process of 
inflammation permitted the introduction of “ irrigation” and “ drain- 
age” of wounds and abscesses as helps to “granulation,” as healing 
of suppurating tissue was then called. 
Healing by first intention has always been regarded with high 
favor. Every method and management conducive to this form of 
healing must be of the highest importance. Transplanting bits of skin 
and epithelial tissue led to such kindly results as to suggest the intro- 
duction of some vehicle into which the blood plasm might be received 
and held in place, to form a clot in the gap of the wound, to be meta- 
morphosed into the scar tissue, taking the place of the lost substance. 
Many forms of animal sutures and of flesh tents were resorted to, 
especially fibrous tissue, in the shape of tendons. 
At length sterilized tents were introduced, which were gradually 
extruded as the new formations progressed in the depths of the wound, 
and had to be cut off from time to time, until at last a mere shred 
remained in the pit left at the site of the former wound tract. Sterili- 
zation is now known as “ Listerism,” and is a great step in advance of 
the old filthy method of uncleanly carelessness. 
The accounts of chicken’s flesh and other forms of non-human 
animal flesh being used to fill gaps of lost tissue, may be dismissed 
with the verdict of “not proven.” 
The accounts of the use of sterilized sponge on the other side of 
the Atlantic led me to try the method in my own practice. The results 
have been so favorable as to induce me to write this paper, with the 
hope of having my brethren become partakers of the benefits of this 
simple and beneficent treatment. Take a case where a portion of the 
flesh has been quite removed by the bite of a dog, the cut of a knife, 
buzz saw, or other free cutting instrument. It is only necessary to 
stanch the bleeding, and fit a bit of sterilized sponge of the size and 
shape of the lost flesh, and to cover it with some impervious dressing 
of oiled silk, sheet rubber, court plaster, gold beater’s skin, husband’s 
plaster, or such like material, over which a light support without press- 
sure should be secured, to keep the exudate from escaping too freely 
by blood pressure. 
When this is done in a healthy subject, we may look for union by 
first intention, without one drop of pus or deteriorated product of 
the albuminoid clot which fills the cavity, and out of which the new 
growth of tissue comes. Destruction of all disease germs which adhere 
to the dressings constitutes the sterilization, or “ Listerism,” which 
proves so conducive to healing by first intention. 4 
A large list of germicides is at our command, which are competent 
to effect sterilization. The chief one, and leading the list, is a solution 
of bichloride of mercury, of from one in five hundred to one in a 
thousand parts of water. 
Sponge grafts conserve the time and energy of the healing process. 
The former manner of determining the point at which to cease dressing 
was to place the finger upon the new growth, and if the plasm broke 
short without adhering to the finger and forming a more or less tena- 
cious rope, which broke as the finger was carried away farther and 
farther, it was deemed necessary to continue stimulating dressings; 
but if the rugae of the finger left their imprint upon the jelly-like mass, 
closing the wound, it was deemed better to protect it from outward 
disturbance by a simple non irritative dressing. If the plasm were so 
watery as not to rope at all, dressing with a coagulant was advisable. 
With the old training to guide us, and the present better under- 
standing of the character and styles of the inflammatory process, we 
are more able to discriminate the indications of favorable progress and 
unfavorable regress of the healing process. 
CORRESPONDENCE. 
Definitions of the lexicons are capable only, of giving the phases of 
meaning already acquired of any word. 
The agreement of things in the cosmos and in the progressive activL 
ties of mind is a sort of correspondence of which dictionaries take no 
cognizance and therefore requires a go-between to find recognition and 
establishment by successive advancements through the open door of 
communication between past, present and future. 
This is the correspondence of progress in nature and in societies of 
every form. 
Personal experience as correspondent of this society has taught me 
the unpleasant lesson that men are more bound up in the merely finan- 
cial and material interests of life than in the acquisition of the knowl- 
edge of the underlying potentiality of moral and intellectual aspects of 
existence whereby the much coveted prize may be cleanly and innocently 
acquired. 
In one word—men are more hungry for the outcome of knowledge, 
properly applied, than for the attainment of the sure grip upon the prin- 
ciples without which its legitimate attainment is impossible. 5 
The commercial spirit is at the bottom of every government on this 
planet, notwithstanding the advancement in science and art. 
Ihe spirit of material riches holds dominion in Church, State and 
Society so firmly, that even the light and intelligence of the later de- 
cades of the igth century yet deem the war element the legitimate 
arbiter of human interest! 
To whom shall we look for the abolition or amelioration of this de- 
moniacal domination ? 
Having in vain hoped for it by following priests, kings, and counsels, 
let us turn our regards to science and practice by throwing away sub- 
terfuge and assumption and embracing truth and righteousness in re- 
search and attainment of the knowledge that can only correspond with 
a true social order. 
The correspondence between sun and earth is the first provable 
example of com-mu ni-ca-tion between giver and receiver of that which 
constitutes individual and associate modes of affection, intelligence 
and bodily conditioned correspondences. * 
The forms of being arising from the con-flu-ence of the radiancy from 
the sun and irradiancy or reflection of sun-impacts, from the earth and 
other planets, are examples of embodiments of types of functioning ma- 
chines. 
The correspondent is, then, the go-between that harmonizes differen- 
ces, compromises difficulties and makes progress possible. 
A machine without the impact of energy by which its purpose is 
effected and revealed, is like the stored energy in germs of typal con- 
struction awaiting the opportunity for the display of configuration of 
personal presence; the manner and habit of the storing of which being 
an important factor; and the immediate proof of classification and 
limitation in suns, systems, planets and inhabitants of planets, so that 
each elemental factor may (must?) contribute its modicum of energy 
to supplement and complete the grand diagram of radiancy and irradi- 
ancy in the harmonic whole. 
This correspondence of affection (emotiveness), intelligence and force 
is the manifestation of the power which produces its embodiments and 
careers which are repeated in kind and degree, but never repeated per se 
in the measureless history of cosmical progression. 
Each organism is the embodiment of possibilities of career equal to 
a plenum, awaiting the opportunity to display its characters of static, 
mode, stato-motic, and moto-static aspects of being as taught by 
Universology. 6 
The unsatisfied desire for solar fulness in planetary voidness is the 
ever coiled-spring of the watch which keeps up the pull upon the power 
by which solar systems spin through space in cosmical order of com- 
pensations of correspondences and dependences ! 
Completeness of satisfactions of desire is death or extinction of the 
desire; so also completeness of explanation of process and definition 
of words would end all further inquiry, and bring verbal correspondence 
to a stand-still of rigidity of significance. 
To say that the vibratory signification in words in the course of pro- 
gress in the history of language, was the record of the vibration in the 
earth’s orbit depending upon the oblate form of its body, would be 
too sudden a burst of interpretation of radiancy to enable all to catch 
at once the relevancy of the correspondence. 
Associations of prime elements produce and maintain the forms of 
bodies which have careers to run of formation, growth, decadence and 
disruption into lower forms or of reconstruction into higher and more 
multiple factors of more complicated examples of individual and as- 
sociate functional activities. 
Elements are of three classes, i. Prime. 2. Proximate, and 3. 
Adventitious or variable elements, the second and third being aggrega- 
tions and modifications of and dependent upon the first so that we can 
only grasp and prove the existence of the first by observing the be- 
havior of the other two in the combinations and separations constitu- 
ting mineral, vegetable, animal and human bodies. 
The manner of storing the correspondent from the sun, known as 
radiance, in the time and in the direction of its impaction marks the 
stages and degrees of impregnation, gestation and parturition. 
And also marks in the individual consciousness—inception, concep- 
tion, perception and comprehension of the processes of production, 
growth, maintenance and dispersion into the occult magma from which 
they spring. 
This is all plainly proven to the faithful observer of the planetary, 
mineral, vegetable, animal and human manifestations of career. 
It will be sufficient to call attention to the protista, protophyta, pro- 
tozoa and rhizopoda as they respond to the differing lengths of day and 
night, and more or less direct ray of sunlight in the rapidity and abund- 
ance or slowness and sparcity of their appearance in the places of their 
habitat. 
And to those who are not miscroscopists we may refer to the differing 
length of the time for the hatching and development of fishes and 7 
the batrachia which is shortened or lengthened in accordance to the 
want or abundance of light. 
The egg of the common brook trout—Salmo-Fontinalis—may be 
hatched in forty days or prolonged to over two hundred days before 
breaking its chitipous shell by appreciation of differing degrees of light 
and heat. 
The larva of the common frog—batrachia esculenta—remains in its 
larval state indefinitely when well fed in the dark. 
Boys who are in the vicinity of ponds and sluggish streams know this 
from observations taken while exploring such places for fish. 
The evolution of language starts with pantomine or mimicry and 
passes through sign or hieroglyph to speech and its record in writing. 
This record is composed of words that are symbols of sounds, the 
modifications of which represent the meaning or signification of the 
simple and multiple forms of sound in speech. 
So writing is the attempt to communicate to others the modes of 
consciousness through which the mind goes in the attainment and pro- 
nouncement of knowledge by the use of symbols of that activity. 
The researches and records of the efforts to attain the science of per- 
ceptible nature made by the fathers; notably Epicurus, Leibnitz and 
Wolf, who recorded the first postulates in matter as “ atoms,” “ monads ” 
and “ simple substances ” in the order named, are so overlain by the 
circumstances of their enrivonment as to render their deductions un- 
certain, and not final, as true science always is. 
The chief objection to the conclusions of our predecessors lies in their 
habit of taking intermediate steps, in the process of tracing the course 
of evolution, as final or really the first step in organization. 
And we will find little help from this discovery if we do not clearly 
trace the line of the influx of the impacts of energy to a more tangible 
origin. 
It is conceded that in every molecular and mass change there are 
at least two factors, viz: an active and a passive force, the compro- 
mise of which presents us with new molecular bodies or change of place 
in massive bodies. 
All who claim but one form of solar impact must remain with inter- 
mediate origins of individual compound bodies, and differentiations of 
their parts and organs. 
The more apparent radiance impact is from the sun, but there is a 
modified solar ray known as stellar radiance—the stars being distant 
suns of other solar systems whose rays impinge upon the earth in an 
attenuated form. 8 
To understand the origin of new bodies, the behavior of active and 
passive forces must be observed and classified as alternately taking the 
lead as acto-passive and passo-active movements in construction and 
variations of functioning bodies. 
It was said that the first provable example of correspondence oc- 
curred between the sun and the earth, and it was intimated that upon 
this depended all subsequent change upon the earth. This is true 
with a little emendation of statement. 
Solar-glintings, stellar-glintings and their reciprocal retro-actions do 
complete the catalogue of construction and destruction of planetary 
activities. 
A complete understanding of the functional history of the lower 
forms of animal bodies cannot be comprehended and accounted for 
without study of the higher and more completely differentiated parts by 
which the different functions are elaborated, viz : the respiratory, circu- 
latory, digestory and sensory systems, whose summations appear to con- 
sciousness through the senses, more plainly in mass, than do the mole- 
cular actions that produce them and without which they cannot exist. 
The sensory and motory functions are operated in two separate con- 
geries of nerves known as ganglionic and cerebro-spinal systems. 
The cerebro-spinal or voluntary system of nerves is the stored radi- 
ancy of stellar impact of energy. 
The ganglionic, sympathetic or involuntary system of nerves is the 
product of solar impact of radiant energy. 
The reciprocal activities of these two embodiments of radiant energy 
produce the respiratory, digestory, secretory, locomotory and conscious 
machinery of the human body. 
A close and comprehensive reading of the foregoing reveals the ne- 
cessity for deep and continuous study and observation in histology, 
anatomy and physiology to fit us for the responsibilities of practice. 
The object of this paper is to induce conjoint efforts in professional 
attainment and progression. And to suggest the propriety of establish- 
ing a system of correspondence between dentists, especially in the so- 
cieties from which this body derives its membership. 
What would the effect be of embodying queries so as to secure 
replies from many investigators ? 
From which a syllabus of well arranged texts, embodying principles 
and practice might be selected, printed and placed in reach of all en- 
gaged in the duties of our profession ?